Free education for PSWs, but at what cost?

The Ontario government plans to train 6000 to 8,000 new PSWs by December 2021, offering free tuition, textbooks and a paid practicum. Given the devastating effects of COVID in Ontario LTC facilities, increasing the work force will help to ensure that all older adults receive excellent care.

This funding will undoubtedly help people to enter the PSW program and will help unemployed people to train or retrain and find new work opportunities. For some who enter the PSW program and then the workforce, they may discover the joy and the rewards that come with caring for elders, with sharing laughter and tears and stories. 

This funding raises many questions.  What about the PSWs who are already in the workforce? In Ontario there are PSWs who are unemployed. There are PSWs without full-time work who used to be able to meet their financial needs by working at more than one facility. For some, their full-time pay is not sufficient to support themselves and their families and the benefits are too often non-existent.

Ontario PSWs responded to this funding announcement with,
“What about us? We need jobs. We need better pay. We need better work conditions.”

This July 2021 report about LTC identifies challenges that PSWs encounter in their work. It leaves me concerned that the following challenges for PSWs will not be addressed by the new funding.

Challenge: Keeping PSWs in the workforce

Did You Know? 40% of PSWs leave within within one year of training.  For every 10 people who graduate, 4 of those leave the profession in the first year.

Working conditions and burnout are the main reasons PSWs leave.

  • 50% of PSWs are retained in the health care sector for fewer than 5 years
    • 43% left the sector due to burnout or working short staffed
  • 25 % of PSWs with two or more years of experience leave the sector annually

 Changes that would help to retain PSWs are:

  • Improved Staffing: Staffing levels need to change so that PSWs can realistically meet the care needs of residents without the risk of burn out. I hope that the government will now provide  increased funding for LTC staffing.
  • Valuing PSWs: A key change would be to integrate PSWs fully into the team, including the way that PSWs are treated. PSWs need to be SEEN and HEARD and VALIDATED! As fully integrated members of the team, they would have opportunities for leadership and education. 
  • Supporting PSWs: With increases in wages and benefits, and full-time jobs possibilities. I hope that the government now provides  increased funding for PSWs to encourage them to stay in their chosen field of work.

Challenge: Preparing PSWs

PSWs need education and training so that they can be prepared to care for people who are living, but are also dying. The report acknowledges that “most residents reach end of life in LTC.” New PSWs must graduate with the skills and knowledge for providing palliative and end-of-life care, and how to integrate a palliative approach.

To fully prepare PSWs to care for people who are living and dying:

  • Provide sufficient education in core curriculum for PSWs to know how to provide palliative care, and integrate a palliative approach.
  • Provide continuing education opportunities on providing palliative care and integrating a palliative approach.

 

In closing, I raise my hands to PSWs, the work that they do and the care they provide. I hope that this free education will be followed with other changes that will benefit all PSWs, and that PSWs will be best able to provide excellent care.

 

Grief during COVID

In an article titled, “There is no vaccine for grief” Maxine Rattner and Marney Thompson write, “While grief itself isn’t a mental-health condition, unsupported grief can turn into one, such as depression and suicidal thinking. And due to the circumstances of COVID, the risk is far higher that grief won’t be supported.” 

Andrea Warnick

 

Andrea Warnick, an educator, registered psychotherapist, nurse and thanatologist was interviewed about grief during COVID on Canada Talks. She describes the challenge to convince people to take the space to grieve – to make space for the difficult feelings. And she emphasized the importance of allowing oneself to  have those difficult feelings. She stressed the importance that even during, perhaps especially during COVID, that people need to connect, share stories, invite stories,… even if we can only do so  online.

The Canadian Grief Alliance has called on the federal government to identify the gaps, the best practices, to develop a national public awareness campaign to help people know about loss, grief and to learn what tends to be helpful/not helpful. In Canada there has been an increase in funding for mental health during covid, but there is a great need for grief specific funding, Some of the strategies for mental health issues do not apply to those who are grieving. For example, “thinking positive thoughts” may not be the best strategy when one needs to find space to cry and allow sadness. 

“Never in our lifetimes has Canada experienced the volume and complexity of grief as has resulted from the COVID-19 pandemic.

(Canadian Grief Alliance)

Canadians have been robbed of goodbyes with dying friends and family or people they care about and forced to grieve in isolation without funeral rites. They and those working on the front lines of health care are at heightened risk for prolonged, complicated grief marked by depression, and the risk of suicide. Existing grief services are fragmented, under-funded and insufficient. Left unaddressed, significant long-term social, health and economic impacts will result.” Canadian Grief Alliance

What are your thoughts on this? How have you seen COVID affect grief in your lives and community?

How do you infuse love in your organization?

Several years ago I was inspired as I read writings from Stephen Post and Thomas Kitwood defining love in dementia care.

“Love within the context of dementia care includes comfort in the original sense of tenderness, closeness, the calming of anxiety and bonding.” (Kitwood, 2003)

“Altruistic love involves both a judgement of worth, and a related affirmative affection. Love is manifest in care, which is love in response to the other in need; it is manifest in compassion, which is love in response to the other in suffering; it is manifest in companionship, which is love attentively present with the other in ordinary moments.” (Post 2003)

As I reflected on their writings, I thought of my esteemed colleague Misha Butot – Fourteen years after graduating as a social worker, while working as a counsellor, educator and yoga teacher, she recognized that love was a theme in all of her work. As a masters student Misha approached people across Western Canada who were involved in social justice work. She asked them if love was relevant in their work and what love in professional practice looked like for them. Even though they were diverse in age, gender, work and focus, ten common themes emerged. Fourteen years later, I approached Misha and asked if we could revisit those themes and translate them into plain English.

As we worked on this “translation” we were inspired by the stories from the research participants, we reflected on our own lives and we wrote a personal commitment to love in our professional practice.

This year, as we consider the most important theme of cultural safety in health care, I am inspired by the thoughts of Dr. James Makokis, an indigenous physician, “Racism is hate. The opposite of hate is love.” and he asks, “How will you infuse love into your organization?”

Racism is hate. The opposite of hate is love.” and he asks, “How will you infuse love into your organization?

Dr James Makokis

In this month of February, as many celebrate Valentine’s Day, love and friendship, I invite you to consider:

What does love look like in your practice?

How do you infuse love into your organization?

I’d love to hear your thoughts.